Why do joints hurt

16 March 2022

Joint pain is not uncommon. Almost half (45 percent) of all people over the age of 45 complain of painful joints, especially knee pain. Symptoms can also occur at a young age. In most cases, joint pain is caused by signs of wear and tear - this is what doctors call arthrosis. In addition, acute arthritis and trauma are common causes of joint pain. But there are many other possible reasons.

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As common as joint pain is, there are so many different types that joint pain is classified according to different criteria. For example, joint pain can be divided into three groups according to when it occurs:

Acute pain in the joints occurs within a few hours.
During the day, subacute pain in the joints becomes noticeable.
Chronic joint pain develops over weeks or months.

Joint pain can often persist and progress (chronic progressive course). Sometimes joint pain is only acute and transient (acute remitting course).

In some cases, joint pain affects only one joint, such as the knee joint. But pain can also involve two to four joints (pain in the oligo-joints) or even more joints (pain in the joints of the joints).

In addition, joint pain varies, for example, in relation to:

Painful rhythm: pain at rest, pain at night, joint stiffness in the morning.
Distribution pattern: pain in small joints (e. g. wrist, knuckles) or large joints (e. g. knee and hip joints), joint pain in the wrist joints, etc.
Pain Intensity: Rating of the severity of joint pain on a scale from 0 (no pain) to 10 (unbearable, extreme pain).
Aggravating factors: for example, reducing joint pain during exercise (typical of arthritis) or after rest (typical of osteoarthritis).

Such information is important for the doctor to determine the causes of joint pain.

Joints affected particularly often

Which joints are most commonly affected by pain depends crucially on the cause of the pain. Some examples.

Osteoarthritis, one of the main causes of joint pain, is particularly noticeable in joints that are subject to heavy use throughout life. These are primarily knee joints, hip joints and ankle joints. Osteoarthritis can also cause pain in all other joints.

Rheumatoid arthritis is also a common cause of joint pain. Painful joint inflammation is most common in the wrists and finger joints. In addition, pain in the knee, elbow, metatarsophalangeal joints, and shoulder is common in rheumatoid arthritis.

Joint pain in an acute attack of gout almost always affects the leg joint, mainly the metatarsophalangeal joint. Ankle and knee joints are also often affected.

Bursitis can cause hip, elbow, knee, and shoulder pain.

Causes and possible diseases

Joint pain can have a variety of causes. The most important are:

Joint wear (arthritis of the joints):Osteoarthritis is the most common form of joint disease and can in principle affect all joints. Due to the destruction of the cartilage layer on the joint surfaces and bone changes, the affected joint cannot move freely, it becomes red, swollen and painful. Osteoarthritis is a common cause of wrist, hip and knee pain. Joint wear is usually caused by permanent overloading of the joints. In addition, arthrosis can be a late consequence of accidents (e. g. sports injuries) and joint damage due to congenital weakness or malformations of the joints.
Bursitis:Bursae are located in the form of a shock-absorbing layer at particularly stressed points between bones and soft tissues, for example in the area of the joints. They usually consist of a cavity filled with synovial fluid. Inflammatory or mechanical irritation (eg, sports injuries) can injure the bursa and cause pain in the affected area. For example, elbow pain is often caused by inflammation of the bursa in the elbow joint, shoulder pain is caused by bursitis or calcification in the shoulder area, knee pain is caused by inflammation of the bursa in the knee joint, and hip pain is caused by inflammation of the bursa at the greater colliculus (bony prominence on the upper outer thigh).
Bacterial joint inflammation (bacterial arthritis):Bacterial arthritis primarily affects knee and hip joints. The bacteria either enter the joint through the blood or infect the joint directly (through trauma or surgery to the joint, or during diagnostic injections into the joint). Severe knee or hip pain with severe joint swelling and inflammatory symptoms (such as redness, localized heat, fever) may indicate bacterial arthritis.
Borreliosis (Lyme arthritis):Joint pain in Lyme disease is also based on bacterial inflammation of the joints. It is caused by certain bacteria (Borrelia burgdorferi) that are transmitted to humans by ticks. Fatigue, fever, redness, and joint pain appear about four weeks after the transfer.
Associated joint inflammation during and after infections.Inflammatory joint pain can occur during and after common infectious diseases such as hepatitis, rubella, mumps, chickenpox, scarlet fever, tuberculosis, influenza and inflammatory bowel disease (Crohn's disease, ulcerative colitis). The resulting joint pain and swelling leads to restricted mobility in the joints, especially in the large joints (hip, knee, ankle).
Arthritis in Reiter's disease:Reiter's syndrome is a rare rheumatic disease. Symptoms include arthralgia associated with urethritis and conjunctivitis.
Inflammation of the joints in psoriasis (psoriatic arthritis):Psoriasis is sometimes accompanied by inflammation that causes joint pain. In some cases, joint pain precedes the skin manifestations of the disease, that is, joint pain appears first, and only then scaly skin lesions develop. Psoriatic arthritis can be the cause, especially if the finger and toe joints and/or the spine are affected.
Joint inflammation in ankylosing spondylitis.Ankylosing spondylitis is a chronic rheumatic inflammation that primarily affects the spine, but can also spread to large joints. Therefore, knee, hip, heel and/or ankle pain can be the cause of Bechterew's disease.
Gout (or acute gout attack):Gout increases the concentration of uric acid in the blood. Your excess is deposited in the form of uric acid crystals in the joints, among other things - an acute attack of gout occurs with severe joint pain, swelling and redness in the joint area. First, the joints of the big toe are affected. However, pain in the knee, wrist, knuckles or upper ankle can also occur during an acute attack of gout.
Rheumatoid arthritis:This is the most common inflammatory disease of the joints, progressive, usually chronic, and gradually devastating the joints. Rheumatoid arthritis can be suspected when joint pain affects the fingers and wrists. Other symptoms of this condition include morning stiffness in the fingers and wrists, swelling in the joints, and an inability to make a fist.
Rheumatic fever:This inflammatory disease, which mostly affects children, is caused by certain bacteria (streptococci) days or weeks after an untreated nose and throat infection. Possible symptoms include inflammatory joint pain, skin symptoms, heart inflammation (carditis), and sudden involuntary and uncontrolled movements (chorea).
Arthritis with sarcoidosis (Löfgren's syndrome):Sarcoidosis is a rare inflammatory disease of unknown cause that can affect any part of the body. One form of the disease is Löfgren's syndrome (acute sarcoidosis). It occurs mainly in young women and presents with the following symptoms: inflammation, joint pain (especially in the ankles), acute inflammation of the subcutaneous fat (erythema nodosum), swelling of the lymph nodes in the lungs (bronchial lymphadenopathy) and weight loss.
Systemic lupus erythematosus (SLE):It's a rare autoimmune disease that mostly affects women and often causes joint pain and inflammation. However, there may be many other different symptoms, such as a butterfly rash on the face, pleurisy, pericarditis, kidney or brain inflammation, loss of appetite and weight loss. Therefore, lupus erythematosus is called a "chameleon" in medicine.
Joint bleeding in violation of coagulation.In rare cases of hemophilia, there is a hereditary predisposition to uncontrollable bleeding after injury or, in severe cases, even for no apparent reason. Bleeding in the muscles and joints is particularly common. Bleeding in the joints can lead to joint pain and permanent joint damage if left untreated. In addition to hemophilia, other bleeding disorders can also lead to joint bleeding and joint pain, such as bleeding disorders caused by an overdose of anticoagulants.

When should you see a doctor?

Joint pain sometimes goes away on its own or can be relieved with simple home remedies. But beware of the following symptoms:

Joint pain that limits movement of the joint.
Fever.
Reddening of the skin around the painful joint.
swelling of the joint.

If joint-related symptoms (joint pain with limited mobility, redness, swelling) last longer than three days, worsen or spread to other joints, you should definitely consult a doctor.

What does the doctor?

To clarify the cause of joint pain, the doctor will first ask the patient about their medical history (anamnesis). For example, when and where does the joint pain occur and whether there are other symptoms (accompanying symptoms such as fever or joint swelling).

Accurate description of joint pain

This information is very important for diagnosing joint pain: The more precisely a patient can describe joint pain, the easier it is for a doctor to narrow down the number of possible causes. For example, an acute attack of gout is thought to cause pain in just one joint. In rheumatoid arthritis, on the other hand, arthralgias are observed in several joints. In addition, the localization (localization) of joint pain is significant: if the patient has pain in the wrist and pain in the basal and middle joints of the fingers, then most likely there is rheumatoid arthritis. However, if the joint pain affects the base of the thumb and knuckles, the suspicion goes in the direction of arthrosis.

Scanning (palpation)

Regardless of where the joint pain occurs, the doctor should clarify the question: Does the joint itself really hurt or does the supposed joint pain come from an area close to the joint or adjacent bones? In some cases, the doctor can find the answer to this question simply by palpating the painful area. However, additional examinations such as X-rays or ultrasounds are very often required.

Further research on joint pain

Such examinations can help identify the cause of pain when joint pain occurs directly in the joint:

Orthopedic examination:If joint pain is caused by wear and tear (arthritis), bursitis, rheumatism or an acute attack of gout, appropriate clues can be found during an orthopedic examination.
Dermatological examination:Skin exams help identify suspected psoriatic arthritis or sarcoidosis as a possible cause of joint pain.
blood tests:Blood tests are useful to identify various causes of joint pain such as: B. bacterial arthritis or Lyme disease. Specific measurements, such as blood clotting, are sometimes needed for a blood test when bleeding in the joint (due to a clotting disorder) can cause joint pain. If rheumatoid arthritis is the cause of joint pain, the blood will first measure rheumatoid factor and other signs of inflammation, which are crucial. And if gout or an acute gout attack is suspected, the focus is on the uric acid level in the blood.
Ultrasound examinations:Ultrasound (ultrasound) is indicated when bursitis, gout, or systemic lupus erythematosus is suspected as the cause of joint pain.
Roentgen:X-ray showing signs of wear and tear on the joints (arthritis), rheumatoid arthritis and ankylosing spondylitis.
joint puncture:If the doctor suspects bacterial joint inflammation as the cause of the joint pain, he takes a joint fluid sample (joint puncture). A bacterial culture is created from this sample: if bacteria grow from the joint sample, this indicates a bacterial inflammation The joint.

It is not always possible to find a disease or pathological tissue change as the cause of joint pain. Doctors speak of "joint sensitivity". Once the cause of the joint pain has been found, the doctor can initiate appropriate treatment and treat the underlying disease with medication or surgery.

You can do it yourself

General tips for joint pain

lose excess weight. Every extra kilogram puts unnecessary additional strain on the joints and contributes to their wear and tear, which inevitably leads to joint pain.
Make sure you get enough rest after your workout.
Do regular cardio exercises to strengthen your muscles and joint cartilage. Swimming and cycling, for example, are suitable for training together. Regular strength training (eg, weight lifting, jumping rope) is also recommended to strengthen bones. Consult an experienced trainer or sports medicine specialist to determine the right dose and develop a balanced exercise program that strengthens all muscles equally.
Avoid one-sided loads such as carrying heavy bags over your shoulder.
According to Jacobson, it is necessary to reduce psychological stress, for example through autogenic training or progressive muscle relaxation. Emotional pressure also puts pressure on joints, shoulders, and bones.
Joint pain and other joint problems are treated with acupuncture in traditional Chinese medicine. Consult an experienced therapist.

Tips for joint treatment

If osteoarthritis is diagnosed, i. e. a recent severe joint inflammation with pain, swelling and redness, you must immobilize the affected joint (bed rest). Hold it in such a way that the muscles connected to it are not strained. Treat yourself to moist and cool compresses (like a curd wrap) to relieve joint discomfort. The effect of anti-inflammatory and analgesic drugs that you receive from your doctor can be enhanced with the help of medicinal plants. Arnica is good (as a decoction for poultices or as an ointment or gel to rub into the joints). There are also, for example, anti-inflammatory and pain-relieving preparations based on willow bark and combination preparations with rosemary and eucalyptus oils. In addition, peppermint oil can relieve pain due to its cooling effect.
Once the joint pain, including redness and swelling, has subsided, the doctor speaks of inactive arthrosis. At this stage of the disease, the resumption of active complaints about the joints is prevented. This is facilitated by adequate, healthy sleep on an orthopedic mattress, as the muscles relax well and the spine and joints rest.
In addition, you should regularly use meditative relaxation techniques (e. g. gradual muscle relaxation, autogenic training) if you often suffer from muscle tension under stress.
Regular exercise and exercises that improve the supply of synovial fluid and nutrients to articular cartilage. Useful sports are swimming, cycling and water aerobics. On the other hand, running on hard ground is not recommended, especially if knee and hip joints are already damaged by arthrosis. If possible, run on soft forest grass and wear sneakers with soft soles that give a good effect. Even better: walking instead of jogging.
Avoid sports with sudden changes in direction (e. g. tennis, squash), as these put a lot of strain on the joints (e. g. knee joint) and quickly cause joint pain.
Try not to stand or sit in one position for a long time.
Eat a diet low in arachidonic acid. This omega-6 fatty acid plays a central role in inflammatory responses (such as arthritis-induced osteoarthritis). Arachidonic acid is found primarily in fatty pork, egg yolks, lard, tuna, liver, beef and camembert.
Consume omega-3 fatty acids regularly as they act as competing analogs of arachidonic acid in inflammatory responses. You can find more of these fatty acids in fish oils (eat fish at least once a week! ).
Make sure you get enough vitamin E, which is important for synovial fluid as it develops its antioxidant effect against inflammation. Vitamin E is found in vegetable oils, particularly wheat, soybean and sunflower germ.
Arthrosis-related joint pain and other joint complaints can often be alleviated by using heat that stimulates circulation, such as fango bags, paraffin, senna, or rosemary baths.
For osteoarthritis of the finger joints, kneading with warm clay or clay can help with joint pain and swelling. Regular finger exercises in the heated sand are also highly recommended. It is especially good for morning stiffness and joint pain.
Massage and rubbing with essential oils of eucalyptus, juniper, rosemary, lavender or lemon help to improve blood circulation and thus counteract joint inflammation.
Devil's claw root tea is recommended for inactive arthrosis: Put a tablespoon of coarsely ground root in two cups of boiling water and let it steep for eight hours. Boil before use, then strain, divide the amount of tea prepared into three portions and drink throughout the day. The effect of taking the devil's claw infusion occurs around the third week of treatment.
A tea mixture of currant leaves, willow bark, nettle grass, horsetail and meadowsweet flowers (20 g component each) is also recommended for the treatment of inactive arthrosis. Take two teaspoons of this mixture and pour a glass of boiling water into it, let it brew for half an hour, and then strain. Drink 5-6 cups of this tea throughout the day. It has an anti-inflammatory and analgesic effect.
Dry cupping and leech therapy (also anti-inflammatory) are also helpful in the treatment of arthrosis irritation. Treatment with autologous blood is controversial, especially if the treated fluid is injected into the joint (risk of infection! ).

Tips for Rheumatoid Arthritis

Some osteoarthritis tips should also apply to people with rheumatoid arthritis. This includes dietary advice, recommendations for topical use of arnica and devil's claw root. Additional tips that can help with rheumatic joint pain and other joint problems:

During periods of mild discomfort (dormant state of rheumatoid arthritis) you can use physical therapy and massage to keep your joints flexible.
With an exacerbation of the inflammatory process (active rheumatoid arthritis), you can prepare an anti-inflammatory tea mixture of meadowsweet, willow bark, goldenrod, currant grass and nettle (20 g each). Pour a tablespoon of this mixture into a cup of cold water and let it stand for an hour. Then bring to a boil, but do not boil! Remove from heat, let rest for five to ten minutes, then strain. Drink three to four cups of this tea daily.
Taking protein-digesting enzymes such as bromelain is said to help with acute joint inflammation.
Highly recommended for rheumatic diseases such as rheumatoid arthritis, Tai Chi and Qigong. Studies show that these are holistic Chinese forms of movement that can improve patients' mobility, muscle strength, endurance, quality of life and mood. According to Chinese medicine, the effect is that calm, flowing movements and breathing exercises release blockages in the body and get the life force (Qi) flowing. Slow exercises are also suitable for patients whose mobility is already restricted by joint pain and inflammation.
Inflammatory joint pain can be relieved with cold or heat treatments - try what works best for you. Cooling is generally recommended for acute joint inflammation in order to stop the inflammation. In the case of chronic complaints, heat is usually more pleasant, such as warming baths (e. g. senna flowers), fango packs or moor packs.
Creams and ointments on medicinal plants also have an anti-inflammatory and pain-relieving effect. These include ready-to-use preparations with willow bark or rosemary and eucalyptus oils. In addition, peppermint oil can reduce the sensation of pain by irritating the cold receptors in the skin.
Ayurveda therapists recommend cleansing procedures (panchakarma cure) for rheumatic diseases in order to remove toxins (called ama) from the body. According to this teaching, the accumulation of Ama is the cause of disease. Indian frankincense (shalaki) and triphala (herb mixture) are used for acute joint inflammation with joint pain. Both have powerful anti-inflammatory effects.